5.4 Vital Wounds
A vital wound represents serious damage to your body. Each vital wound has a specific detrimental effect on you. You gain vital wounds when
your hit points go negative (see Negative Hit Points).
To determine the effect of a vital wound, make a vital roll and find the corresponding effect in Table 5.1: Vital Wound Effects. The effect of the
vital wound lasts until you remove that vital wound. The effects of vital wounds stack with each other, even if you roll the same effect twice for
different vital wounds.
5.4.1 Vital Rolls
To make a vital roll, roll 1d10. You take a penalty to this roll equal to twice the number of vital wounds you already have, not counting the vital wound you are rolling for. This includes vital wounds that have no specific vital wound effect. The result determines the effect of the vital wound, as listed in Table 5.1: Vital Wound Effects. Vital wound effects from vital rolls below 1 are lethal if untreated, but the Medicine skill can be used to prevent you from dying (see Medicine). This roll is not a check, so you can’t affect it with abilities like desperate exertion .
| Vital Roll | Effect |
| -6 or less | You immediately die |
| 0–-5 | You are unconscious, and you die after one minute |
| 1 | You are unconscious while you have less than half hit points |
| 2 | You take a -1 penalty to accuracy |
| 3 | You have a -5 foot penalty to your speed with all movement modes |
| 4 | Your maximum damage resistance is halved |
| 5 | You take a -2 penalty to your fatigue tolerance |
| 6 | You take a -1 penalty to all defenses |
| 7 | You take a -2 penalty to your Fortitude defense |
| 8 | You take a -2 penalty to your Reflex defense |
| 9 | You take a -2 penalty to your Mental defense |
| 10 or more | No extra vital wound effect |
5.4.2 Removing Vital Wounds
Vital wounds take time to heal. Whenever you finish a long rest, you remove one of your vital wounds. If you have multiple vital wounds, you may choose the order in which your vital wounds are removed.